<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c"%>
<script type="text/javascript" src="${pageContext.request.contextPath}/js/web/case/caseinput.js"></script>	
<div class="table-responsive">
	<table>
	<tr><td>
	<form id="patient_info" class="pagclass" action="">
		<table style="font-size: 14px;margin: 10 20 10 10;">
			<tr height="35px;">
				<td width="20%;">姓名：<input name="patientFormMap。patient_name" id="patient_name" type="text" style="80px;"><input type="hidden" id="patient_id" name="patientFormMap。id"><input type="button" value="选择" style="height: 21px;font-size: 12px;border: 1px solid #696969;" onclick="selpatient()"></td>
				<td width="20%;">性别：<select id="patient_sex" name="patientFormMap。patient_sex">
					<option value="女">女</option>
					<option value="男">男</option>
				</select>
				</td>
				<td width="20%;">
				年龄：<input name="patientFormMap。patient_age" id="patient_age" type="text" width="40">
				</td>
				<td width="20%;">编号：<input name="patientFormMap。patient_number" id="patient_number" disabled="true" type="text" style="80px;"></td>
			</tr>
			<tr height="35px;">
				<td>电话：<input type="text" id="patient_phone" name="patientFormMap。patient_phone" ></td>
				<td colspan="2">地址：<input type="text" id="patient_address" name="patientFormMap。patient_address" style="width: 380px;"></td>
				<td style="text-align: right;"><button type="reset" onclick="resetfm();" class="btn btn-success btn-s-xs">重置</button>&nbsp<button type="button" onclick="savepatient();" class="btn btn-success btn-s-xs" style="margin-right: 50px;">保存</button></td>
			</tr>
		</table>
	</form>
	</td></tr>
	<tr><td>
	<table style="font-size: 16px;margin: 10 20 10 10;">
		<tr height="35px;">
			<td>
			请选择分类：
				<select name="type_no" style="font-size: 14px;" onchange ="selseries();">
					<c:forEach items="${illnesstype}" var="i">
						<option value="${i.no}">${i.name}</option>
					</c:forEach>
				</select>
			</td>
		</tr>
		<tr height="35px;">
			<td>请选择系列：</td>
		</tr>
		<tr>
			<td id="serieshtml" style="border: 1px solid gray;padding: 10px;">
				<c:forEach items="${series}" var="s">
					<span style="width: 33%; float: left; height: 30px; line-height: 30px;">
						<input type="checkbox" name="series" style="margin-right: 10px;" value="${s.no}">${s.name}
					</span>
				</c:forEach>
			</td>
		</tr>
		<tr>
			<td style="text-align: right;padding-right: 50px;">
				<button type="button" onclick="getdiagnosis();" class="btn btn-success btn-s-xs" >确定</button>
			</td>
		</tr>
	</table>
	</td></tr>
	</table>
	</div>
